Remote Test Lead — Payer Systems & QA

HealthEdge Software, Inc.; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

HealthEdge Software, Inc. is seeking a Test Lead II with healthcare payer domain expertise to drive test planning and execution for payer system engagements.

The role is hands-on, owning test case design, defect management, and daily execution quality while collaborating with the Test Manager and cross-functional delivery teams. The position requires 5+ years in QA/testing, 2+ years in a lead role, and solid experience testing U.S.

Qualifications

• 5+ years in software QA/testing.
• 2+ years in a lead or senior tester role.
• Solid experience testing U.S. healthcare payer systems — claims, enrollment, benefits, or provider network.
• Working knowledge of EDI X12 transactions and HIPAA compliance requirements.
• Hands-on test case design using boundary analysis, equivalence partitioning, and negative testing techniques.
• Proficiency in defect tracking and test management tools (JIRA, Zephyr, ALM, or equivalent).
• Ability to read payer business rules, EOPs, benefit plan documents, and SLAs.
• Strong attention to detail — payer system defects have financial and compliance consequences.

Responsibilities

• Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows.
• Lead functional, integration, regression, and UAT cycles for assigned payer modules.
• Analyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution begins.
• Own defect lifecycle management: logging, triage, root cause classification, retest, and closure tracking.
• Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards.
• Support compliance and regulatory test cycles — ICD updates, CMS mandates, state-specific Medicaid rules.
• Coordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behavior.
• Produce daily/weekly execution status reports with defect metrics, coverage status, and risk flags.
• Manages offshore QA analysts.

Skills

Test planning

Lead role

Payer systems testing

Requirements analysis

Test design techniques

Defect management

Attention to detail

Tools

JIRA

Zephyr

ALM

Job description

HealthEdge Software, Inc. is seeking a Test Lead II with healthcare payer domain expertise to drive test planning and execution for payer system engagements.

The role is hands-on, owning test case design, defect management, and daily execution quality while collaborating with the Test Manager and cross-functional delivery teams. The position requires 5+ years in QA/testing, 2+ years in a lead role, and solid experience testing U.S.